Care at NUH

Services for Subfertility - Male

Microsurgical Varicocelectomy

Many men with varicoceles can conceive without issues, but for some, it may impact fertility. Varicoceles, which involves dilated veins in the scrotum, can be addressed through surgery, specifically varicocelectomy, to improve semen parameters. However, increased conception rates are not guaranteed.  

We specialise in microsurgical varicocelectomy, offering better visualisation of small abnormal vessels and achieving higher success rates. 

Risks associated with microsurgical varicocelectomy include: 

  • Persistent/recurrent varicocele; 
  • Testicular tenderness and bruising; 
  • Infection; 
  • Hydrocoele (collection of fluid around the testis); and 
  • Testicular loss (rare). 
Sperm Extraction and Assisted Reproductive Surgery

In cases of extremely low sperm counts or absence of sperm in the ejaculate due to blocked ejaculatory ducts, several techniques can be used to extract sperm directly from the testis. These include: 

  1. Percutaneous/microsurgical epididymal sperm aspiration (PESA/MESA); 
  2. Testicular sperm extraction/aspiration (TESE/TESA); and 
  3. Microsurgical testicular sperm extraction (micro-TESE). 

Sperm harvested through these technqiues can then be used in Assisted Reproductive Technologies (ART), including in vitro fertilisation (IVF) and intracytoplasmic sperm injection (ICSI), to facilitate pregnancy. 

These procedures, usually performed under general anaesthesia for patient comfort, are relatively straightforward. However, potential risks include pain, bleeding, infection, damage to the testis and failure to retrieve viable sperm. 

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